Endoxan
✅ Treats various cancers
✅ Suppresses immune system
✅ Controls autoimmune diseases
✅ Reduces inflammation
✅ Manages nephrotic syndrome
Endoxan contains Cyclophosphamide.
✓ Medicinskt granskad av Morgan Ellis — Apoteksforskare · 8 års erfarenhet · Senast granskad: maj 2026
⚡ Quick Answer — What is Endoxan?
Endoxan is an oral tablet from Baxter containing cyclophosphamide 50 mg — an alkylating cytotoxic agent (nitrogen mustard derivative) used for haematological malignancies, breast cancer (CMF / AC regimens), severe autoimmune disease (lupus nephritis, ANCA vasculitis), and bone marrow conditioning. Standard low-dose oral regimens: 1–3 mg/kg/day or pulsed weekly cycles, prescribed by specialist. Mandatory monitoring: FBC every 1–2 weeks, urine for haemorrhagic cystitis, fertility preservation discussion before starting. Plenty of fluids (3 L/day during active dosing) to flush bladder and prevent haemorrhagic cystitis from acrolein metabolite. Pregnancy contraindication; gonadotoxic with permanent infertility risk — offer fertility preservation in reproductive-age patients.
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What Is Endoxan?
Endoxan is an oral tablet from Baxter containing cyclophosphamide 50 mg. Cyclophosphamide is a prodrug alkylating cytotoxic agent (nitrogen mustard family). It is metabolised in the liver to active 4-hydroxycyclophosphamide and the toxic metabolite acrolein. Used in many haematological cancers, solid tumours and severe autoimmune diseases.
Användningsområden och indikationer
- Haematological: chronic lymphocytic leukaemia, low-grade non-Hodgkin lymphoma, multiple myeloma, Waldenström macroglobulinaemia, conditioning before stem cell transplant
- Solid tumours: breast cancer (CMF, AC regimens), small-cell lung cancer, ovarian cancer, neuroblastoma, sarcoma (high-dose IV)
- Severe autoimmune disease: lupus nephritis, ANCA-associated vasculitis (granulomatosis with polyangiitis, microscopic polyangiitis), refractory rheumatoid arthritis
- Off-label: nephrotic syndrome (steroid-resistant), pemphigus vulgaris
Dosage and How to Take
Oral regimens vary by indication; specialist prescribing only. Examples for adults:
- Low-dose continuous oral: 1–3 mg/kg/day
- Pulsed oral cyclophosphamide for vasculitis: 50–200 mg/day
- Take in the morning with plenty of fluid — aim for at least 3 L of fluid intake per day during active dosing to flush the bladder of acrolein and reduce haemorrhagic cystitis risk.
- Empty bladder frequently. Consider mesna prophylaxis at higher cumulative dose under specialist guidance.
- Take with food if nausea occurs. Antiemetic (ondansetron) 1 hour before if needed.
- Swallow tablets whole. Do NOT crush. Caregivers handling tablets should wash hands.
- Mandatory monitoring: FBC every 1–2 weeks; urinalysis monthly (haematuria); LFTs monthly; baseline + ongoing renal function.
- Fertility preservation: discuss before starting in reproductive-age patients. Cyclophosphamide is gonadotoxic — sperm banking, oocyte / embryo cryopreservation, or GnRH-agonist ovarian protection should be offered.
Biverkningar
Vanligt: nausea, vomiting (preventable with antiemetics), alopecia, anorexia, mucositis, fatigue.
Viktigt:
- Myelosuppression — nadir at 7–10 days; full recovery by day 21
- Haemorrhagic cystitis — from acrolein bladder toxicity; prevent with high fluid intake (3 L/day) and frequent bladder emptying; mesna for high-dose regimens
- Permanent infertility — gonadotoxic; sperm banking and oocyte preservation should be offered before starting in reproductive-age patients
- Bladder cancer (long-term, dose-related)
- Secondary leukaemia / myelodysplastic syndrome
- Cardiotoxicity (mostly high-dose IV regimens)
- Pulmonary fibrosis (rare)
- SIADH and water intoxication (high-dose IV)
Varningar
- Pregnancy: teratogenic and abortifacient. Strict contraception throughout treatment + 12 months after for women, 6 months for men.
- Breastfeeding: contraindicated.
- Severe hepatic or renal impairment: reduce dose, specialist guidance.
- Live vaccines: contraindicated.
- Active urinary tract infection: treat before starting.
- Caregivers: wear gloves when handling tablets or contaminated body fluids; wash exposed skin immediately.
Läkemedelsinteraktioner
| Kombinera med | Effekt | Vad man ska göra |
|---|---|---|
| Allopurinol | Raises cyclophosphamide marrow toxicity | Monitor FBC closely. |
| Warfarin | INR variability | Monitor INR weekly. |
| Live vaccines | Disseminated infection | Contraindicated. |
| Other immunosuppressants | Additive infection risk | Specialist supervision. |
| CYP3A4 inhibitors / inducers | Modify activation of cyclophosphamide prodrug | Specialist review. |
Förvaring
- Room temperature, 15–25°C, original blister.
- Out of reach of children, women of childbearing potential, pets.
- Caregivers wear gloves when handling.
Relaterade alternativ på MedsBase
Other oncology medications stocked alongside this product:
- Celkeran (chlorambucil 2 / 5 mg)
- Temotero (temozolomide 20 / 100 mg)
- Temozol (temozolomide 20 mg)
- Lomoother (lomustine 40 mg)
- Endace (megestrol 40 / 160 mg)
Browse all anti-cancer medications →
Vanliga frågor
Why do I need so much fluid on Endoxan?
Cyclophosphamide produces a toxic metabolite called acrolein that concentrates in the bladder and causes haemorrhagic cystitis — bleeding from the bladder wall. Aggressive hydration (at least 3 L of fluid per day during active dosing) flushes acrolein out before it damages the bladder. Empty your bladder frequently and avoid holding urine overnight if possible. For higher-dose regimens, mesna (a thiol drug that neutralises acrolein) is prescribed.
Will Endoxan make me infertile?
Yes — cyclophosphamide is gonadotoxic and may cause permanent infertility, especially with cumulative doses > 5–7 g/m² and in older reproductive-age patients. Fertility preservation should be offered before starting in any reproductive-age patient: sperm banking (men), oocyte or embryo cryopreservation (women), or GnRH-agonist ovarian protection during treatment. Discuss with the oncologist before the first dose.
What blood tests do I need?
Mandatory: FBC every 1–2 weeks (nadir at days 7–10, recovery by day 21); urinalysis monthly (haematuria detection); LFTs monthly; baseline + ongoing renal function. Inform your specialist of any blood in urine, fever, mouth ulcers, or unusual bleeding.
Why is bladder cancer a long-term risk?
Long-term cyclophosphamide exposure increases bladder cancer risk, dose-related and cumulative-dose-related. After a course of cyclophosphamide, regular urinalysis (at least annually) for haematuria is reasonable; cystoscopy if persistent haematuria. Stop smoking — smoking compounds the bladder cancer risk dramatically.
Can I get pregnant on Endoxan?
No — cyclophosphamide is teratogenic and abortifacient. Reliable contraception throughout treatment AND for at least 12 months after the last dose (women) or 6 months (men). Discuss family planning with your specialist; consider fertility preservation before starting.
Can I have live vaccines?
No — live vaccines (MMR, yellow fever, BCG, oral polio, varicella) contraindicated during cyclophosphamide and for 3–6 months after stopping. Inactivated vaccines (annual flu, pneumococcal, COVID-19) are not only safe but recommended.
What infections should I watch for?
Cyclophosphamide-induced lymphopenia raises risk of opportunistic infections. Seek same-day care for any fever > 38°C, persistent cough, breathlessness, severe diarrhoea, or new rash. PCP prophylaxis (co-trimoxazole) may be prescribed at higher doses or in transplant settings.
Caregivers handling Endoxan — any precautions?
Yes — cyclophosphamide tablets and patient body fluids (urine, vomit) for the first 48 hours after a dose contain cytotoxic compounds. Caregivers should wear gloves when handling tablets, contaminated linen, or body fluids; wash hands afterwards; double-flush the toilet. Pregnant caregivers should avoid handling cyclophosphamide entirely.
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Related Anti-Cancer Medications
Other oncology medications stocked alongside this product:
- Celkeran (chlorambucil 2 mg)
- Lomoother (lomustine 40 mg)
- Folitrax (methotrexate 2.5/7.5/10 mg)
- Imutrex (methotrexate 2.5/7.5/10 mg)
- Hydrosar (hydroxyurea 500 mg)
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| Styrka | 50 mg |
|---|---|
| Kvantitet | 30 tabletter, 60 tabletter, 90 tabletter, 180 tabletter |
Endoxan
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